Cystic Hygroma Follow-up

  • Author: Jason L Acevedo, MD; Chief Editor: Glenn C Isaacson, MD, FACS, FAAP   more...
 
Updated: Jul 22, 2011
 

Complications

Complications include airway obstruction, hemorrhage, infection, and deformation of surrounding bony structures or teeth if left untreated.

Complications from the surgical excision of a cystic hygroma (CH) are myriad and are related to the location and structures adjacent to the mass; these include damage to a neurovascular structure (including cranial nerves), chylous fistula, chylothorax, hemorrhage, and recurrence. Most recurrences occur within the first year but have been reported to occur as long as 10 years after excision.

Next

Prognosis

Unlike in hemangiomas, spontaneous resolution of CH is uncommon. Recurrence is rare when all gross disease is removed. If residual tissue is left behind, the expected recurrence rate is approximately 15%.

In prenatal CH, diagnosis after 30 weeks' gestation is considered a positive prognosticator.

Previous
 
Contributor Information and Disclosures
Author

Jason L Acevedo, MD  Assistant Professor of Surgery, Uniformed Services University of the Health Sciences, Department of Otolaryngology, Fort Sill, Oklahoma

Jason L Acevedo, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American College of Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Rahul K Shah, MD, FACS, FAAP  Assistant Professor of Otolaryngology and Pediatrics, George Washington University School of Medicine and Health Sciences; Attending Physician, Department of Otolaryngology, Children's National Medical Center

Rahul K Shah, MD, FACS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Medical Quality, American College of Physician Executives, American College of Surgeons, Massachusetts Medical Society, Phi Beta Kappa, and Triological Society

Disclosure: Nothing to disclose.

Holly L Neville, MD  Assistant Professor of Clinical Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine

Holly L Neville, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, and Association of Women Surgeons

Disclosure: Nothing to disclose.

Michael D Poole, MD, PhD  Consulting Staff, Georgia Ear Institute

Michael D Poole, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Society for Microbiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Orval Brown, MD  Director of Otolaryngology Clinic, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas

Orval Brown, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Bronchoesophagological Association, American College of Surgeons, American Medical Association, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

John E McClay, MD  Associate Professor of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Dallas, University of Texas Southwestern Medical School

John E McClay, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Medical Association

Disclosure: Nothing to disclose.

Paul D Petry, DO, FACOP, FAAP  Consulting Staff, Freeman Pediatric Care, Freeman Health System

Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Chief Editor

Glenn C Isaacson, MD, FACS, FAAP  Professor of Otolaryngology-Head and Neck Surgery and Pediatrics, Temple University School of Medicine

Glenn C Isaacson, MD, FACS, FAAP is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Bronchoesophagological Association, American College of Surgeons, American Laryngological Rhinological and Otological Society, American Society of Pediatric Otolaryngology, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Covidien Honoraria Consulting

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Charles S Cox, Jr, MD, to the development and writing of this article.

References

  1. Perkins JA, Manning SC, Tempero RM, Cunningham MJ, Edmonds JL Jr, Hoffer FA, et al. Lymphatic malformations: current cellular and clinical investigations. Otolaryngol Head Neck Surg. Jun 2010;142(6):789-94. [Medline].

  2. Tanna N, Sidell D, Schwartz AM, Schessel DA. Cystic lymphatic malformation of the middle ear. Ann Otol Rhinol Laryngol. Nov 2008;117(11):824-6. [Medline].

  3. Bloom DC, Perkins JA, Manning SC. Management of lymphatic malformations. Curr Opin Otolaryngol Head Neck Surg. Dec 2004;12(6):500-4. [Medline].

  4. de Serres LM, Sie KC, Richardson MA. Lymphatic malformations of the head and neck. A proposal for staging. Arch Otolaryngol Head Neck Surg. May 1995;121(5):577-82. [Medline].

  5. Kuang-Tao Y. Detection of chylothorax and cervical cystic hygroma in hydrops fetalis using lymphoscintigraphy. Clin Nucl Med. Apr 2006;31(4):205-6. [Medline].

  6. Giguere CM, Bauman NM, Smith RJ. New treatment options for lymphangioma in infants and children. Ann Otol Rhinol Laryngol. Dec 2002;111(12 Pt 1):1066-75. [Medline].

  7. Wheeler JS, Morreau P, Mahadevan M, Pease P. OK-432 and lymphatic malformations in children: the Starship Children's Hospital experience. ANZ J Surg. Oct 2004;74(10):855-8. [Medline].

  8. Ozen IO, Moralioglu S, Karabulut R, et al. Surgical treatment of cervicofacial cystic hygromas in children. ORL J Otorhinolaryngol Relat Spec. 2005;67(6):331-4. [Medline].

  9. Niramis R, Watanatittan S, Rattanasuwan T. Treatment of cystic hygroma by intralesional bleomycin injection: experience in 70 patients. Eur J Pediatr Surg. May 2010;20(3):178-82. [Medline].

  10. Sainsbury DC, Kessell G, Fall AJ, Hampton FJ, Guhan A, Muir T. Intralesional bleomycin injection treatment for vascular birthmarks: a 5-year experience at a single United Kingdom unit. Plast Reconstr Surg. May 2011;127(5):2031-44. [Medline].

  11. Impellizzeri P, Romeo C, Borruto FA, Granata F, Scalfari G, De Ponte FS, et al. Sclerotherapy for cervical cystic lymphatic malformations in children. Our experience with computed tomography-guided 98% sterile ethanol insertion and a review of the literature. J Pediatr Surg. Dec 2010;45(12):2473-8. [Medline].

  12. Burezq H, Williams B, Chitte SA. Management of cystic hygromas: 30 year experience. J Craniofac Surg. Jul 2006;17(4):815-8. [Medline].

  13. Acevedo JL, Shah RK, Brietzke SE. Nonsurgical therapies for lymphangiomas: a systematic review. Otolaryngol Head Neck Surg. Apr 2008;138(4):418-24. [Medline].

  14. Albanese CT, Wiener ES. Cystic hygroma. In: Spitz L, Coran AG, eds. Pediatric Surgery. London: Chapman & Hall; 1995:94-9.

  15. Barnes L. Tumors and tumor-like lesions of the soft tissues. In: Surgical Pathology of the Head and Neck. Vol 2. 2001:904-7.

  16. Cummings CW. Vascular tumors and malformations of the head and neck. In: Cummings Otolaryngology Head and Neck Surgery. Vol 4. 1998:4020-1.

  17. Dries AM, McDermott J. Diagnosis of cystic lymphangioma of the pancreas with endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol. Apr 2008;103(4):1049-50. [Medline].

  18. Feins NR, Raffensperger JG. Cystic hygroma, lymphangioma, and lymphedema. In: Raffensperger JG, ed. Swenson's Pediatric Surgery. 5th ed. Norwalk: 1990:167-72.

  19. Mulliken JB, Glowacki J. Classification of pediatric vascular lesions. Plast Reconstr Surg. Jul 1982;70(1):120-1. [Medline].

  20. Peters DA, Courtemanche DJ, Heran MK, et al. Treatment of cystic lymphatic vascular malformations with OK-432 sclerotherapy. Plast Reconstr Surg. Nov 2006;118(6):1441-6. [Medline].

  21. Tran-Ngoc-Ninh, Tran-Xuan-Ninh. Cystic hygroma in children: a report of 126 cases. J Pediatr Surg. Apr 1974;9(2):191-5. [Medline].

  22. Wesley JR. Pediatric head and neck. In: Greenfield LJ, Mulholland M, Oldham KT, et al, eds. Surgery. 1997:1999.

 
Previous
Next
 
Reconstruction of CT in sagittal dimension. This patient was intubated because of respiratory distress caused by the large lymphatic malformation.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.